A Novel Cell Delivery System Exploiting Synergy between Fresh Titanium and Fibronectin.

Delivering and retaining cells in areas of interest is an ongoing challenge in tissue engineering. Here we introduce a novel approach to fabricate osteoblast-loaded titanium suitable for cell delivery for bone integration, regeneration, and engineering. We hypothesized that titanium age influences the efficiency of protein adsorption and cell loading onto titanium surfaces. Fresh (newly machined) and 1-month-old (aged) commercial grade 4 titanium disks were prepared. Fresh titanium surfaces were hydrophilic, whereas aged surfaces were hydrophobic. Twice the amount of type 1 collagen and fibronectin adsorbed to fresh titanium surfaces than aged titanium surfaces after a short incubation period of three hours, and 2.5-times more fibronectin than collagen adsorbed regardless of titanium age. Rat bone marrow-derived osteoblasts were incubated on protein-adsorbed titanium surfaces for three hours, and osteoblast loading was most efficient on fresh titanium adsorbed with fibronectin. The number of osteoblasts loaded using this synergy between fresh titanium and fibronectin was nine times greater than that on aged titanium with no protein adsorption. The loaded cells were confirmed to be firmly attached and functional. The number of loaded cells was strongly correlated with the amount of protein adsorbed regardless of the protein type, with fibronectin simply more efficiently adsorbed on titanium surfaces than collagen. The role of surface hydrophilicity of fresh titanium surfaces in increasing protein adsorption or cell loading was unclear. The hydrophilicity of protein-adsorbed titanium increased with the amount of protein but was not the primary determinant of cell loading. In conclusion, the osteoblast loading efficiency was dependent on the age of the titanium and the amount of protein adsorption. In addition, the efficiency of protein adsorption was specific to the protein, with fibronectin being much more efficient than collagen. This is a novel strategy to effectively deliver osteoblasts ex vivo and in vivo using titanium as a vehicle.

Effect of ultraviolet photoactivation of titanium on osseointegration in a rat model.

PURPOSE: The objective of this study was to determine whether ultraviolet (UV) light treatment of titanium implants could enhance osseointegration to sufficiently overcome the negative aspects of shorter implants in a rat femur model. MATERIALS AND METHODS: Acid-etched miniature titanium implants with lengths of 2 mm (longer implants) and 1.2 mm (shorter implants) were prepared. Some of these implants were treated with UV light for 48 hours prior to surgery. The strength of osseointegration generated by these implants was evaluated using a biomechanical implant push-in test in a rat model. Peri-implant osteogenesis was examined by scanning electron microscopy for tissue morphology and energy dispersive x-ray spectroscopy for elemental composition. RESULTS: Push-in test values for the longer implants were 80% and 100% greater than those of the shorter implants at weeks 4 and 8 of healing, respectively. UV treatment of the shorter implants significantly increased their push-in value, resulting in a 100% higher value than untreated longer implants at week 2 and a push-in value that was equivalent to that of the untreated longer implants at weeks 4 and 8. Scanning electron micrographs and energy dispersive x-ray spectroscopic examinations after push-in testing revealed that the UV-treated implant surfaces were covered more extensively by bone or tissue remnants containing calcium and phosphorous than the untreated surfaces. The titanium surfaces were converted from hydrophobic to superhydrophilic status after UV treatment, although the cause-result relationship between the acquired superhydrophilicity and biologic effects remained unclear. CONCLUSIONS: Within the limits of this investigation, UV light pretreatment substantially enhanced the osseointegration capacity of acid-etched titanium implants. The deficiencies of osseointegration in implants with a 40% shorter length were overcome by UV treatment in the rat model using miniature implants. These results need to be confirmed in other animal models and implants that more closely resemble human dental implants to determine the true clinical significance.

Alleviation of commercial collagen sponge- and membrane-induced apoptosis and dysfunction in cultured osteoblasts by an amino acid derivative.

PURPOSE: The objectives of this in vitro study were to determine whether the commercial collagen material used in bone augmentation procedures induces oxidative stress-mediated adverse effects on the viability and function of osteoblasts and to determine whether N-acetyl cysteine (NAC), an antioxidant amino acid derivative, can alleviate these effects. MATERIALS AND METHODS: Commercial collagen sponge (Collaplug) and membrane (BioGide) were treated with NAC. Rat calvaria-derived osteoblasts were directly seeded on these materials with or without NAC pretreatment. Cytotoxic evaluation was performed by flowcytometric cell viability assay, confocal laser microscopic analysis of attached cell morphology and reactive oxygen species (ROS) localization, and alkaline phosphatase staining. RESULTS: Cell viability was less than 40% on both collagen sponge and membrane 24 hours after seeding and increased to 50% with NAC pretreatment. Cell death was characterized by apoptosis. Colonization of attached cells was sparse on the untreated sponge and membrane on day 1, and the cells were round, small, and filled with intense and closely packed intracellular ROS. In contrast, NAC-pretreated material had dense cell colonies consisting of well-spread osteoblasts and fully developing cytoskeleton and cellular processes with little ROS generation. On day 7 of culture, NAC-pretreated collagen sponge and membrane yielded an expanded alkaline phosphatase-positive area occupying 60% and 80% of the surface area, respectively, whereas the untreated collagen materials had limited alkaline phosphatase activity (7% or less). CONCLUSIONS: Commercial collagen sponge and membrane induced considerable cell death, impaired initial function, and generated extraordinary intracellular ROS in attached osteoblasts, whereas NAC pretreatment substantially ameliorated these effects. The potential benefits of NAC's detoxifying capacity on bone regeneration using collagen matrix materials in an animal model should be confirmed with further study.

Ultraviolet light treatment for the restoration of age-related degradation of titanium bioactivity.

PURPOSE: To examine the bioactivity of differently aged titanium (Ti) disks and to determine whether ultraviolet (UV) light treatment reverses the possible adverse effects of Ti aging. MATERIALS AND METHODS: Ti disks with three different surface topographies were prepared: machined, acid-etched, and sandblasted. The disks were divided into three groups: disks tested for biologic capacity immediately after processing (fresh surfaces), disks stored under dark ambient conditions for 4 weeks, and disks stored for 4 weeks and treated with UV light. The protein adsorption capacity of Ti was examined using albumin and fibronectin. Cell attraction to Ti was evaluated by examining migration, attachment, and spreading behaviors of human osteoblasts on Ti disks. Osteoblast differentiation was evaluated by examining alkaline phosphatase activity, the expression of bone-related genes, and mineralized nodule area in the culture. RESULTS: Four-week-old Ti disks showed = or < 50% protein adsorption after 6 hours of incubation compared with fresh disks, regardless of surface topography. Total protein adsorption for 4-week-old surfaces did not reach the level of fresh surfaces, even after 24 hours of incubation. Fifty percent fewer human osteoblasts migrated and attached to 4-week-old surfaces compared with fresh surfaces. Alkaline phosphatase activity, gene expression, and mineralized nodule area were substantially reduced on the 4-week-old surfaces. The reduction of these biologic parameters was associated with the conversion of Ti disks from superhydrophilicity to hydrophobicity during storage for 4 weeks. UV-treated 4-week-old disks showed even higher protein adsorption, osteoblast migration, attachment, differentiation, and mineralization than fresh surfaces, and were associated with regenerated superhydrophilicity. CONCLUSIONS: Time-related degradation of Ti bioactivity is substantial and impairs the recruitment and function of human osteoblasts as compared to freshly prepared Ti surfaces, suggesting a "biologic aging"-like change of Ti. UV treatment of aged Ti, however, restores and even enhances bioactivity, exceeding its innate levels.

CAG repeat size correlates to electrophysiological motor and sensory phenotypes in SBMA.

Spinal and bulbar muscular atrophy (SBMA) is an adult-onset, lower motor neuron disease caused by an aberrant elongation of a CAG repeat in the androgen receptor (AR) gene. The main symptoms are weakness and atrophy of bulbar, facial and limb muscles, but sensory disturbances are frequently found in SBMA patients. Motor symptoms have been attributed to the accumulation of mutant AR in the nucleus of lower motor neurons, which is more profound in patients with a longer CAG repeat. We examined nerve conduction properties including F-waves in a total of 106 patients with genetically confirmed SBMA (mean age at data collection = 53.8 years; range = 31-75 years) and 85 control subjects. Motor conduction velocities (MCV), compound muscle action potentials (CMAP), sensory conduction velocities (SCV) and sensory nerve action potentials (SNAP) were significantly decreased in all nerves examined in the SBMA patients compared with that in the normal controls, indicating that axonal degeneration is the primary process in both motor and sensory nerves. More profound abnormalities were observed in the nerves of the upper limbs than in those of the lower limbs. F-waves in the median nerve were absent in 30 of 106 cases (28.3%), but no cases of absent F-waves were observed in the tibial nerve. From an analysis of the relationship between CMAPs and SNAPs, patients were identified with different electrophysiological phenotypes: motor-dominant, sensory-dominant and non-dominant phenotypes. The CAG repeat size and the age at onset were significantly different among the patients with motor- and sensory-dominant phenotypes, indicating that a longer CAG repeat is more closely linked to the motor-dominant phenotype and a shorter CAG repeat is more closely linked to the sensory-dominant phenotype. Furthermore, when we classified the patients by CAG repeat size, CMAP values showed a tendency to be decreased in patients with a longer CAG repeat (> or =47), while SNAPs were significantly decreased in patients with a shorter CAG repeat (<47). In addition, we found that the frequency of aggregation in the sensory neuron cytoplasm tended to inversely correlate with the CAG repeat size in the autopsy study, supporting the view that the CAG repeat size differentially correlates with motor- and sensory-dominant phenotypes. In conclusion, our results suggest that there are unequivocal electrophysiological phenotypes influenced by CAG repeat size in SBMA.

The video images of sleep attacks in Parkinson's disease.

We describe a sleep attack, which was induced by taking excessive levodopa and pergolide, in a 73-year-old woman with Parkinson's disease. At the onset of the sleep attack, her head suddenly sagged and sometimes hit the table, but she did not notice these symptoms. Her family noticed that this sleep attack occurred when she began to speak slowly. Her family recorded this attack with a video camera. This sleep attack resolved with control of her medication. This is the first report of video images of a sleep attack due to excessive levodopa and a dopamine agonist.

Influence of ultraviolet irradiation treatment on porcelain bond strength of titanium surfaces.

To determine the effect of titanium (Ti) surface modification by ultraviolet irradiation (UVI) on the bond strength between Ti and porcelain. Grade 2 Ti plates were allotted to five groups: sandblasted (SA), 15 min UVI (UV), SA+5 min UVI (SA+UV5), SA+10 min UVI (SA+UV10), and SA+15 min UVI (SA+UV15). After surface treatment, porcelain was added. A precious metal (MC) was used for comparison with Ti. The effects of 24-h storage at room temperature versus thermal cycling only at 5 and 55°C in water were evaluated. Subsequently, the tensile strength of each sample was tested. Data were analyzed using one-way analysis of variance and the Tukey test. In both the room temperature and thermal cycling groups, the MC and SA+15 min UVI samples showed significantly greater bond strengths than the other samples (p<0.05). UVI processing efficiently increases the bond strength between porcelain and the Ti surface.

Effects of biting on elevation of blood pressure and other physiological responses to stress in rats: biting may reduce allostatic load.

We have investigated how biting modulates some of the physiological changes (blood pressure, core temperature, and chemical mediators in the serum) that are induced by restraint stress. We exposed rats to restraint stress for 60 min. Biting on a wooden stick during restraint significantly suppressed the increase of blood pressure at 30, 45, 60, and 75 min and significantly inhibited the rise in core temperature at 30, 60, 120, and 180 min compared with rats that were restrained but did not bite anything. These differences were visible in infrared thermal images of the restraint-only and restraint-with-biting rats after 60 min. Biochemical analysis revealed that biting significantly suppressed increases of plasma interleukin-1beta, interleukin-6, and leptin and that it significantly suppressed a decrease of thyroid-stimulating hormone. These observations suggest that biting produces an anti-stress effect and that para-functional masticatory activity plays an important role in coping with stressful events.

Suppression of stress immobilization-induced phosphorylation of ERK 1/2 by biting in the rat hypothalamic paraventricular nucleus.

We have previously reported that acute immobilization stress induces Fos protein. Fos protein is generally used as a marker for neuronal activity and has been linked to phosphorylation of extracellular signal-regulated protein kinase 1/2 (pERK1/2), in the hypothalamic paraventricular nucleus (PVN). Biting behavior during the period of stress reduced the expression of Fos protein. The present immunohistochemical study was designed to determine whether acute immobilization stress induces pERK1/2 in the PVN, and whether the stress-induced pERK1/2 was attenuated by simultaneous biting behavior. Acute immobilization stress, in increments of up to 15min, produced detectable amounts of pERK1/2 that were proportional to the interval of stress. Biting during the acute immobilization stress significantly reduced the amount of detectable pERK1/2. These results suggest that biting activity during acute stress inhibits pERK1/2 in this region of the brain. It is feasible that the neuronal cellular response to acute stress is regulated, in some part, by inhibition of pERK1/2 by biting.

Assessment of oxidative stress in the spontaneously hypertensive rat brain using electron spin resonance (ESR) imaging and in vivo L-Band ESR.

This study examined the blood brain barrier (BBB)-permeable nitroxyl compound, 3-methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine-1-oxyl (MC-PROXYL), as a spin probe for the assessment of oxidative stress in the brain by electron spin resonance (ESR) imaging and in vivo L-band ESR. Preliminary comparisons were made by ESR imaging of MC-PROXYL in the isolated brains of normal Wistar-Kyoto rats (WKY), spontaneously hypertensive rats (SHR), and stroke prone SHR (SHRSP). The decay of the ESR images of MC-PROXYL in the isolated brains was faster in SHR than in normal WKY, but was only moderate in SHRSP. In addition, the decay rate of MC-PROXYL in the heads of live rats, as measured noninvasively by L-band ESR, was faster in SHR than in WKY, and was slower in SHR than in SHRSP. Taken together, our data suggest that the oxidative stress of SHR is not as high as that in high oxidative stress animal models such as SHRSP. This is the first study to present reconstructed 3D images of the distribution of MC-PROXYL in the isolated SHR brain. The ESR technique employed herein appears to be a powerful tool for evaluating oxidative stress and for detecting the region of oxidative stress in the brain of SHR.

Measurement of oxidative stress in the rodent brain using computerized electron spin resonance tomography.

The strategy of this study was to improve the electronic spin resonance (ESR) application used to detect free radical-induced oxidative stress in animal models. We have developed an in vivo ESR imaging system with high-quality ESR-computed tomography (CT) images by using a nitroxyl spin probe--BBB-permeable, 3-methoxycarbonyl-2,2,5,5-tetramethyl-pyrrolidine-1-yloxy (MC-PROXYL)--in living small animals. We first measured the distribution of MC-PROXYL in the head region of a living mouse by using ESR-CT imaging after treatment with MC-PROXYL. In the ESR-CT experiments, it was clearly observed that MC-PROXYL was well distributed in the brain of head region of a living mouse. The ESR-CT images taken after treatment with MC-PROXYL demonstrate that the decay of MC-PROXYL in the isolated brain of a spontaneously hypertensive rat (SHR) was more rapid than that in a Wister Kyoto rat. ESR-CT analysis revealed that the region of rapid decay might be located in the cerebral cortex of the isolated brain of an SHR. These results suggest that the present study of ESR-CT imaging would be a useful tool for monitoring and detecting the locations of oxidative stress in the brains of rodent animal models.

Impaired pain processing in Parkinson's disease and its relative association with the sense of smell.

BACKGROUND AND PURPOSE: Many non-motor symptoms are associated with Parkinson's disease (PD). Of these, pain and olfactory disturbance tend to be common premotor symptoms. PD has been shown to exhibit abnormal central pain processing, although underlying mechanisms are not yet fully understood. In order to investigate this further, we assessed PD patients by specific Aδ stimulation with intra-epidermal needle electrode and determined olfactory function. METHODS: Forty-two patients (18 males and 24 females) with PD and 17 healthy control subjects (8 males and 9 females) were studied. A thin needle electrode was used to stimulate epidermal Aδ fibers, and somatosensory evoked potentials (SEPs) recorded at the vertex. Olfactory function was evaluated using the Odor Stick Identification Test for Japanese (OSIT-J) and its relationship with pain-related SEPs was investigated. RESULTS: There were no significant differences in N1 latencies or P1 latencies although N1/P1 peak-to-peak amplitudes were significantly lower (p < 0.01) in PD patients than in control subjects. In PD patients, there were significant correlations between N1/P1 amplitudes and disease duration (r = -0.35, p < 0.05), Hoehn-Yahr stage (r = -0.38, p < 0.05) and UPDRS part III (r = -0.42, p < 0.01). Furthermore, the OSIT-J scores correlated with SEP amplitude (r = 0.41, p < 0.01). CONCLUSION: Pain processing in PD patients was impaired under specific nociceptive stimulation of Aδ fibers and significant correlation with smell dysfunction was detected. We suggest that this mechanism may involve the limbic system during PD pathology.

Evaluation of denture base resin after disinfection method using reactive oxygen species (ROS).

The effects of certain disinfectants on the stability of a polymethyl methacrylate denture base resin were investigated, including those of a novel disinfection method using reactive oxygen species (ROS). The surface roughness and flexural strength were analyzed to assess the effects of the disinfectants on material properties. The following disinfectants were tested: 5% sodium hypochlorite, 70% alcohol, and ROS. Furthermore, the attachment of Candida albicans to the resin surface was investigated. The disinfection method using sodium hypochlorite significantly increased the surface roughness and decreased flexural strength. The surface roughness and flexural strength of the ROS-treated specimens did not significantly differ from those of the control specimens, and the ROS-treated specimens exhibited diminished Candida attachment. These results demonstrate that the ROS disinfection method preserves acceptable material stability levels in polymethyl methacrylate resins.

Enhanced biological responses of a hydroxyapatite/TiO2 hybrid structure when surface electric charge is controlled using radiofrequency sputtering.

We investigated whether surface roughness and control of surface electric charge of a hydroxyapatite (HA)/titanium oxide (TiO2) hybrid coating could enhance biological responses associated with bone formation. After acid etching, a titanium surface was modified with HA and TiO2 by the dual sputtering deposition technique using radiofrequency sputtering. These surfaces were analyzed for surface roughness and surface electric charge intensity. Rat bone marrow-derived osteoblast-like cells were cultured on HA/TiO2 hybrid surfaces with different electric charges. The attachment and spreading behavior of these cells were significantly increased on the hybrid surface (p<0.05). In vivo experiment, the strength of bone-titanium implant integration with a hybrid surface was 3 times that of a control (p<0.05). The dual sputtering deposition technique created a HA/TiO2 hybrid structure. Our results show that the surface electric charge on a titanium surface is an important factor for enhancing biological responses.

Bone integration capability of nanopolymorphic crystalline hydroxyapatite coated on titanium implants.

The mechanism by which hydroxyapatite (HA)-coated titanium promotes bone-implant integration is largely unknown. Furthermore, refining the fabrication of nano-structured HA to the level applicable to the mass production process for titanium implants is challenging. This study reports successful creation of nanopolymorphic crystalline HA on microroughened titanium surfaces using a combination of flame spray and low-temperature calcination and tests its biological capability to enhance bone-implant integration. Sandblasted microroughened titanium implants and sandblasted + HA-coated titanium implants were subjected to biomechanical and histomorphometric analyses in a rat model. The HA was 55% crystallized and consisted of nanoscale needle-like architectures developed in various diameters, lengths, and orientations, which resulted in a 70% increase in surface area compared to noncoated microroughened surfaces. The HA was free from impurity contaminants, with a calcium/phosphorus ratio of 1.66 being equivalent to that of stoichiometric HA. As compared to microroughened implants, HA-coated implants increased the strength of bone-implant integration consistently at both early and late stages of healing. HA-coated implants showed an increased percentage of bone-implant contact and bone volume within 50 µm proximity of the implant surface, as well as a remarkably reduced percentage of soft tissue intervention between bone and the implant surface. In contrast, bone volume outside the 50 µm border was lower around HA-coated implants. Thus, this study demonstrated that the addition of pure nanopolymorphic crystalline HA to microroughened titanium not only accelerates but also enhances the level of bone-implant integration and identified the specific tissue morphogenesis parameters modulated by HA coating. In particular, the nanocrystalline HA was proven to be drastic in increasing osteoconductivity and inhibiting soft tissue infiltration, but the effect was limited to the immediate microenvironment surrounding the implant.

Soft-food diet induces oxidative stress in the rat brain.

Decreased dopamine (DA) release in the hippocampus may be caused by dysfunctional mastication, although the mechanisms involved remain unclear. The present study examined the effects of soft- and hard-food diets on oxidative stress in the brain, and the relationship between these effects and hippocampal DA levels. The present study showed that DA release in the hippocampus was decreased in rats fed a soft-food diet. Electron spin resonance studies using the nitroxyl spin probe 3-methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine-1-oxyl directly demonstrated a high level of oxidative stress in the rat brain due to soft-food diet feeding. In addition, we confirmed that DA directly react with reactive oxygen species such as hydroxyl radical and superoxide. These observations suggest that soft-food diet feeding enhances oxidative stress, which leads to oxidation and a decrease in the release of DA in the hippocampus of rats.

Gamma ray treatment enhances bioactivity and osseointegration capability of titanium.

The time-dependent degradation of titanium bioactivity (i.e., the biological aging of titanium) has been reported in previous studies. This phenomenon is caused by the loss of hydrophilicity and the inevitable occurrence of progressive contamination of titanium surfaces by hydrocarbons. In this study, we tested the hypothesis that gamma ray treatment, owing to its high energy to decompose and remove organic contaminants, enhances the bioactivity and osteoconductivity of titanium. Titanium disks were acid-etched and stored for 4 weeks. Rat bone marrow-derived osteoblasts (BMOs) were cultured on titanium disks with or without gamma ray treatment (30 kGy) immediately before experiments. The cell density at day 2 increased by 50% on gamma-treated surfaces, which reflected the 25% higher rate of cell proliferation. Osteoblasts on gamma-treated surfaces showed 30% higher alkaline phosphatase activity at day 5 and 60% higher calcium deposition at day 20. The strength of in vivo bone-implant integration increased by 40% at the early healing stage of week 2 for gamma-treated implants. Gamma ray-treated surfaces regained hydrophilicity and showed a lower percentage of carbon (35%) as opposed to 48% on untreated aged surfaces. The data indicated that gamma ray pretreatment of titanium substantially enhances its bioactivity and osteoconductivity, in association with the significant reduction in surface carbon and the recovery of hydrophilicity. The results suggest that gamma ray treatment could be an effective surface enhancement technology to overcome biological aging of titanium and improve the biological properties of titanium implants.

Tremor is attenuated during walking in essential tremor with resting tremor but not parkinsonian tremor.

We used accelerometry and visual examination by a neurologist to measure the intensity and frequency of hand tremor under resting, postural, writing, and walking conditions among patients with essential tremor with resting tremor (n=11) and Parkinson's disease (n=38). The intensity of essential tremor was markedly attenuated during walking relative to resting. The intensity and frequency of parkinsonian tremors were higher while walking than while resting. We suggest that assessment of the intensity and frequency of tremor during walking is clinically useful for differentiating between essential tremor with resting tremor and parkinsonian tremor, especially in the early stages, when the two conditions are often difficult to distinguish. Parkinsonian tremors are known to be enhanced during walking. Our clinical experience, as well as that of others, suggests that the intensity of essential tremor with resting tremor is markedly attenuated during walking.

Effects of UV photofunctionalization on the nanotopography enhanced initial bioactivity of titanium.

This study addresses the control of the biological capabilities of titanium through specific nanosurface features and its potential modulation by UV photofunctionalization. Rat bone marrow derived osteoblasts were cultured on titanium disks with micropits alone, micropits with 100 nm nodules, micropits with 300 nm nodules, or micropits with 500 nm nodules, with or without UV treatment. After a 24 h incubation protein adsorption, as well as the attachment, retention, and spread of osteoblasts were examined in correlation with the topographical parameters of the titanium substrates. Each of the biological events was governed by a different set of multiple surface topographical factors with a distinctive pattern of regulation. For instance, without UV treatment the protein adsorption and cell attachment capability of titanium substrates increased linearly with increasing average roughness (Ra) and surface area of titanium disks, but increased polynomially with increasing nanonodule diameter. The cell retention capability increased polynomially with increasing nanonodular diameter and Ra, but increased linearly with increasing surface area. Consequently, the micropits with 300 nm nodules created the most favorable environment for this initial osteoblast behavior and response. UV treatment of the nanonodular titanium surfaces resulted in considerable enhancement of all biological events. However, the pattern of UV-mediated enhancement was disproportionate; exponential and overriding effects were observed depending upon the biological event and topographical parameter. As an example of overriding enhancement, the cell retention capability, which fluctuated with changes in various topographical parameters, became invariably high after UV treatment. The present data provide a basis for understanding how to optimize nanostructures to create titanium surfaces with increased biological capabilities and uncover a novel advantage of UV photofunctionalization of titanium substrates that synergistically increases its nanotopography enhanced biological capabilities whereby most of the initial biological events of osteoblasts were overwhelmingly enhanced beyond a simple proportional increase.

Management of oral candidiasis in denture wearers.

In many cases, dentists try to manage denture pain by adjusting dentures. However, some patients complain of oral discomfort over a long period even after appropriate denture adjustments. In some of these situations, simple denture adjustment does not alleviate the discomfort of these patients. It is known that denture stomatitis may occur in response to plaque accumulation on dentures. One of the chief pathogenic microorganisms causing this type of inflammation is Candida albicans. A common symptom of oral candidiasis is pain in the oral mucosa complicated by angular stomatitis. In this paper, we report a case of oral candidiasis that was diagnosed and managed based on the patient's complaints.